Perception of changes in wall tension of the proximal stomach in humans

• Published in: Gut Vol. 49; no. 2; pp. 203 - 208
• Main Authors: Piessevaux, H, Tack, J, Wilmer, A, Coulie, B, Geubel, A, Janssens, J
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd and British Society of Gastroenterology 01.08.2001; BMJ; BMJ Publishing Group Ltd; BMJ Publishing Group LTD
• Subjects: Abdomen; Abdominal pain; Adult; Analysis of Variance; Area Under Curve; barostat; Biological and medical sciences; Catheters; Causes of; Diagnosis; Erythromycin; Erythromycin - administration & dosage; Female; Functional investigation of the digestive system; Gastrointestinal Agents - administration & dosage; Health aspects; Humans; Indigestion; Investigative techniques, diagnostic techniques (general aspects); Male; Manometry; mechanoreceptors; Mechanoreceptors - drug effects; Mechanoreceptors - physiology; Medical examination; Medical sciences; Pain Threshold - drug effects; Pain Threshold - physiology; Palpation; Perception - drug effects; Perception - physiology; Perceptions; Stomach; Stomach - drug effects; Stomach - physiology; Stress, Physiological - drug therapy; Stress, Physiological - physiopathology; Studies; visceral hypersensitivity; wall tension; United Kingdom; Human; Proximal; Stomach; Wall; Dyspepsia; Hypersensitivity; Asymptomatic; Change; Erythromycin; Macrolide; Antibiotic; Digestive diseases; Perception; Physiology; Tension; Baroreceptor; Antibacterial agent; Elongation; Gastric disease
• ISSN: 0017-5749; 1468-3288; 1458-3288
• DOI: 10.1136/gut.49.2.203

BACKGROUND Hypersensitivity to distension of the stomach is a frequent finding in functional dyspepsia. During gastric distension studies both wall tension and elongation are increased. AIM We wished to distinguish changes in wall tension from changes in elongation in the genesis of perception of mechanical stimuli originating from the proximal stomach in healthy subjects. SUBJECTS AND METHODS Twenty six volunteers were studied using gastric barostat and antroduodenal manometry. In 14 subjects, stepwise isobaric and isovolumetric distensions were performed before and during erythromycin infusion. In all volunteers, on a separate occasion, phasic contractions of the proximal stomach were detected as intraballoon pressure increases during fixed volume inflation. These contractions were matched with perception changes during two 10 minute periods, before and during administration of erythromycin. RESULTS Erythromycin significantly lowered the perception and discomfort thresholds during stepwise gastric distension. During fixed volume inflation, erythromycin increased the number and amplitude of fundic contractions and enhanced their perception from 51.1 (7.4)% to 64.0 (4.7)%. The proportion of perception score increases coinciding with fundic contractions increased from 47.3 (0.7)% to 81.5 (0.5)%. The amplitude of correctly identified isolated fundic pressure waves was higher compared with non-identified waves. CONCLUSIONS These results support the hypothesis that changes in gastric wall tension may be involved in the genesis of symptoms originating from the stomach.